Mabry, Lara M.
Mabry, Lara M. is an sole proprietor health care provider with primary practice located at 2601 Boniface Pkwy , Anchorage AK 99504-3106. She recently has only one registered license in Dental Providers / Dentist, which is considered as her primary health care specialty. Mabry, Lara M. can be contacted via phone (907) 337-9448.Contact Information
Primary practice address
2601 Boniface Pkwy
Anchorage AK 99504-3106
Phone: (907) 337-9448
Fax: (907) 337-4123
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | 1200 | Alaska |
Profile Details
| NPI number | 1780737395 |
|---|---|
| LBN Legal business name | Mabry, Lara M. |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 18th, 2007 |
| Last updated | Jul 9th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1780737395 | NPPES |
| Alaska | MEDICAID | DD2601 |
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